Healthcare Provider Details

I. General information

NPI: 1720673817
Provider Name (Legal Business Name): GIBSON GENERAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4604 US HIGHWAY 60 W
MORGANFIELD KY
42437-6515
US

IV. Provider business mailing address

PO BOX 1197
EVANSVILLE IN
47706-1197
US

V. Phone/Fax

Practice location:
  • Phone: 703-895-0002
  • Fax: 270-333-9292
Mailing address:
  • Phone: 270-389-5000
  • Fax: 270-333-9292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LOIS MORGAN
Title or Position: VP
Credential:
Phone: 812-385-9237